Tobramycin
injection (Nebcin) |
Category:
Description:
Indications:
-
Bacterial
infections (P. aeruginosa,
Proteus species (including P.
mirabilis), M. morganii, E.
coli, P. vulgaris, Klebsiella-Enterobacter-Serratia group, Citrobacter species, Staphylococcus species)
-
Septicemia
(P. aeruginosa, E. coli,
Klebsiella species)
-
Lower
respiratory tract infections (P.
aeruginosa, E. coli, Klebsiella species, Enterobacter species, Serratia species, S. aureus)
-
Serious
bacterial infections of the CNS (meningitis)
-
Intra-abdominal
infections, including peritonitis (,
E. coli, Klebsiella species, Enterobacter species)
-
Skin,
bone and soft tissue infections (P.
aeruginosa, Proteus species,
E. coli, Klebsiella species, Enterobacter species, S. aureus)
-
Complicated
and recurrent urinary tract infections (P.
aeruginosa, Proteus species, E. coli, Klebsiella species, Enterobacter species, Serratia species, Citrobacter species, Providencia species, S.
aureus)
-
Cystic
fibrosis nebulization therapy (P.
aeruginosa)
Contraindications:
Precautions:
-
Pregnancy
category D
-
May
cause nephrotoxicity, therefore closely monitor renal function,
especially in elderly patients.
-
May
cause ototoxicity, therefore monitor hearing
-
Monitor
peak and trough serum concentrations
-
In
patients with extensive burns, altered pharmacokinetics may alter
serum concentrations.
-
May
produce hypomagnesemia, especially if poor or restricted diet.
-
Aminoglycosides
have neuromuscular blockade activity with a curare-like effect. Monitor patient’s neuromuscular function, especially in
patients with myasthenia gravis, parkinsonism or infant botulism.
-
Cystic
fibrosis patients may have altered pharmacokinetics, requiring reduced
dosages
Adverse
Reactions (Side Effects):
-
Central
and peripheral nervous system reactions: Headache, delerium,
confusion, lethargy
-
Gastrointestinal:
vomiting, nausea, anorexia, hypersalivation
-
Hematologic:
changes in reticulocyte counts, anemia, altered WBC counts
-
Hypersensitivity:
rash, urticaria, itching
-
Special
senses: dizziness, tinnitis, vertigo
-
Renal:
clinduria, oliguria, proteinuria, increased creatinine and BUN
-
Miscellaneous:
apnea, alopecia, joint pain
-
Pain
at injection site
-
Decreased
calcium, sodium, potassium and magnesium levels
|
Dosage:
-
Administered
by IM or IV injection or nebulization
-
Therapy
duration is generally 7-10 days
-
Dosages
based on patients ideal body weight
Adults: normal
renal function: 3mg/kg/day IV or IM in 3 equal doses every 8 hours |
Weight
(pounds) |
Weight
(kg) |
Q8 hour Dose (Moderate Infections) |
132 |
60 |
60 mg IM/IV |
154 |
70 |
70 mg IM/IV |
176 |
80 |
80 mg IM/IV |
198 |
90 |
90 mg IM/IV |
Serious infections:
5mg/kg/day divided into 3-4 equal doses |
Weight
(pounds) |
Weight
(kg) |
Q8 hour Dose (Serious Infections) |
132 |
60 |
100 mg IM/IV |
154 |
70 |
117 mg IM/IV |
176 |
80 |
133 mg IM/IV |
198 |
90 |
150 mg IM/IV |
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The information contained here is an
abbreviated summary. For more detailed and complete information, consult the
manufacturer's product information sheets or standard textbooks
Source: Operational Medicine 2001, Health
Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau
of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington,
D.C., 20372-5300
This information is provided by The Brookside Associates. The Brookside
Associates, LLC. is a private organization, not affiliated with any governmental
agency. The opinions presented here are those of the author and do not
necessarily represent the opinions of the Brookside Associates or the Department
of Defense. The presence of any advertising on these pages does not constitute
an endorsement of that product or service by either the US Department of Defense
or the Brookside Associates. All material presented here is unclassified.
C. 2009, 2014, All Rights Reserved
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